NHS cannot meet autism or ADHD demand, report says

The “extraordinary” rise in demand for autism assessments and ADHD treatments in England has overtaken the NHS’s capacity to meet it, a think tank says.

Since 2019, there has been a 400% rise in people waiting to see an autism specialist and a 51% increase in prescriptions for ADHD medication, according to the Nuffield Trust.

“Pumping more money” into the current system would not help, it warned.

Instead, a “radical rethink” was needed for the NHS to keep up with demand.

Nuffield Trust chief executive Thea Stein said it was “frankly impossible to imagine how the system can grow fast enough to fulfil this demand”.

“We’re at a really critical point as a society, where we’re actually understanding neurodiversity and the fact that it’s a much greater spectrum for the whole of society than we’ve ever had before,” she told BBC News.

“It’s a really complicated issue for us to all collectively understand as a society.”

One out of every 100 people is on the autistic spectrum, it is estimated, while 2.6 million people in the UK haveattention deficit hyperactivity disorder (ADHD) .

The Nuffield Trust said 24% of patients referred for ADHD in England were having to wait one to two years for an assessment.

And 172,000 adults and children are on a waiting list for an autism assessment – the highest recorded figure – according to NHS data analysed by the think tank,

Between October and December 2023, the median time spent on a waiting list after an autism referral rose to over nine months, compared with four months in the same period in 2019.

And in Derbyshire, the waiting time was two and half years, according to the report.

The way NHS Digital collects data has changed since 2019 – but Ms Stein is confident it remains robust.

The rise in demand was probably due to greater awareness of the conditions and changing social attitudes, the Nuffield Trust said.

And the number of prescriptions for ADHD medication for adults has grown even faster than for children and teenagers, according to separate data.

Ms Stein warned long waits would have a “serious effect” on children in particular, as many schools provided extra support only after a diagnosis.

“We’ve certainly got to have a different approach within educational services that says you don’t need that letter in your hand,” she said.

People should not have to have a diagnosis just “to get a label out of it”.

And wider societal change was needed “to allow ourselves to include more people who present with more neurodiversity”.

“We are going to need to think in a much more creative way than simply have a conversation that says we need more NHS resources, as that isn’t the solution,” Ms Stein added.

The charity Child Autism said the spike since 2019 may be party due to the suspension of some services during the pandemic, causing a backlog.

Its chief executive, Suzy Yardley, agreed a new “coherent UK-wide plan” was needed.

“Autistic children have huge amounts to contribute, and we need an overhaul of the system to ensure this can happen”, she said.

Dr James Cusack, chief executive of the charity Autistica, said: “It has been evident for some time that services need to adapt to the knowledge that there are more neurodivergent people than we used to think.”

And there was a “need to focus on each person’s strengths and needs so that they get the support they need earlier”.

A Department of Health and Social Care official said: “We know it’s vital to have a timely diagnosis of autism or ADHD and we are taking action to reduce assessment delays.

“NHS England has published a national framework to help speed up autism assessments and is establishing a new ADHD taskforce alongside the government, to improve care for people living with the condition.

“In addition, our £13m partnership with NHS England will help improve specialist support for neurodiverse children in primary schools.”